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Increased Incidence of Cardiovascular Conditions Among Older Adults With Pathological Gambling Features in a Prospective Study

Pilver, Corey E. PhD; Potenza, Marc N. MD, PhD

doi: 10.1097/ADM.0b013e31829e9b36
Original Research

Objectives: To evaluate the prospective associations between at-risk/problem/pathological gambling (ARPG) and incident medical conditions among older adults.

Methods: Secondary data analysis of the National Epidemiologic Survey on Alcohol and Related Conditions, waves 1 and 2, collected from 2001 to 2002 and 2004 to 2005, respectively. Participants are adults aged 55 years and older (n = 10,231) who were selected from a nationally representative community sample of adults residing in the United States. Past-year diagnostic criteria for pathological gambling at wave 1 were evaluated with the Alcohol Use Disorder and Associated Disabilities Interview Schedule—Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition. Physical health conditions were assessed at wave 1 and wave 2. Logistic regression modeling was conducted on groups categorized as ARPG (participants endorsing 1 or more inclusionary criteria for pathological gambling) and non-ARPG (nongambling/low-frequency gambling or gambling without endorsement of pathological gambling criteria).

Results: Relative to non-ARPG, ARPG is prospectively associated with elevated incidences of arteriosclerosis and any heart condition, independently of wave-1 sociodemographic characteristics, psychiatric comorbidity, substance use, and body mass index.

Conclusions: Older adults who demonstrate risky or problematic levels of gambling may be at particular risk for the onset of some physical health conditions. Individuals with at-risk/problem/pathological gambling features should be monitored more closely for the development of these conditions and encouraged to adopt activities that confer health benefits. Efforts should be made to educate older adults and their caretakers on the adverse incident physical health conditions associated with ARPG.

From the Department of Biostatistics (CEP), Yale School of Public Health, New Haven, CT; and Departments of Psychiatry (MNP) and Neurobiology (MNP) and Yale Child Study Center (MNP), Yale University School of Medicine, New Haven, CT.

Send correspondence and reprint request to Marc N. Potenza, MD, PhD, Connecticut Mental Health Center, Room S-104, 34 Park St, New Haven, CT 06519. E-mail:

Supported in part by the National Institute of Mental Health training grant T-32-MH01 4235-37, National Institutes of Health (NIH) grants from the National Institute on Alcohol Abuse and Alcoholism (RL1 AA017539), the Connecticut State Department of Mental Health and Addictions Services, the Connecticut Mental Health Center, an unrestricted research gift from the Mohegan Sun Casino, and the Yale Gambling Center of Research Excellence Award grant from the National Center for Responsible Gaming.

The funding agencies did not provide input or comment on the content of the article, and the content of the article reflects the contributions and thoughts of the authors and do not necessarily reflect the views of the funding agencies.

The authors disclose the following for past-12-month activities. Dr Potenza reports no conflicts of interest related to the content of this study. He has consulted Lundbeck and Ironwood pharmaceuticals; received research support from the NIH, Mohegan Sun Casino, and National Center for Responsible Gambling; has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse-control disorders, or other health topics; has consulted law offices on issues related to addictions or impulse-control disorders; has consulted gambling agencies and entities on responsible gambling efforts; has provided clinical care in the Connecticut Department of Mental Health and Addiction Services Problem Gambling Services Program; has performed grant reviews for the NIH and other agencies; has guest edited journal sections; has given academic lectures in grand rounds, Continuing Medical Education events, and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts. Dr Pilver reports no financial or other potential conflicts of interest related to the subject of this article.

Received March 19, 2013

Accepted June 01, 2013

© 2013 American Society of Addiction Medicine